| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
115 |
104 |
$8K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
66 |
62 |
$7K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
32 |
32 |
$670.72 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
33 |
33 |
$369.27 |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
35 |
35 |
$364.35 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
16 |
15 |
$217.28 |